Ezra Klein has an article whose thesis is that as Americans don’t directly pay the full cost of their healthcare since employers pay a large chunk, or they’re on Medicare, Medicaid or some form of socialized medicine (the military and the Veterans administration) Americans aren’t for radical change.
The problem with this is simple enough. Polls find that a super majority of Americans, from 70% to 80% want a public option. A straight up majority want single payer. That certainly qualifies as radical change.
Americans may not pay the full cost of insurance, but they are well aware of the full cost of health care. About 60% of all bankruptcies are caused by health bills, everyone who is self-employed knows the full cost, and people who get sick routinely had claims denied or lose coverage. The full cost of healthcare becomes evident when you get sick, and the health care you thought your insurance provided doesn’t actually appear, or you have to fight tooth and nail for it.
Everyone may not have experienced these costs and problems directly, but I’d be willing to lay long odds that almost no Americans haven’t had them happen to a friend, co-worker or family member.
And so, contra-Ezra, in fact Americans are ready for radical change. Even if you don’t consider the public option radical, single payer is, and a majority of Americans want it. One might argue that that the intensity of desire for change is not there, that there haven’t been huge crowds in support of health care change, but the problem there is Obama has been rather wishy-washy. He isn’t offering single payer, which is what would get the hard left out in large numbers, and he isn’t even willing to say that his bill must have a strong public option. His plan, and those offered by the House and Senate, have a mushy feel to them. “Might pass this, might not, and we aren’t committed to it.”
It’s hard to get worked up for mush and so, by and large, people aren’t.
But still, it’s clear Americans want radical change of the health care system. It’s the politicians who don’t.
Specifically Democratic conservative Senators like Baucus and Conrad, virtually every Republican Senator, and President Barack Obama, who ruled out radical change in the form of single payer and who won’t insist on even a bad public option, let alone a truly robust one, are the ones who don’t want radical change.
And yes, it’s probably because American politicians don’t feel the cost of health care: they’re fully covered, and virtually all of them are millionaires.
So, no, the problem isn’t American citizens not having the appetite for necessary radical change. The problem is American politicians.
BDBlue
I would add that the handing of “reform” so that lots of Americans don’t get motivated to actually come out and support it fully and vocally is, as they say, a feature and not a bug. The reason single payer never got a seat at the table is not because it’s so unpopular – if that were the case, you’d simply give the activists a seat to make your left wing happy and then ignore them – it’s because it would be incredibly popular. So popular, the politicians might not be able to stop it.
That’s one of the many reasons why it’s been so disappointing to see single payer disappear not only from the press, but also from a large part of the “progressive” blogosphere. Because it gives weight to the idea that our political elite decide what’s on and off the table, when we should be the ones deciding that or at least trying to.
BDBlue
D’oh, handling not handing.
vastleft
To be fair to President Obama, did he ever claim to represent “change”?
Ian Welsh
hahahaha, very funny VL
masslib
Exactly. It’s becoming the CW to blame Americans, blame teabaggers, blame “low information voters”, etc.. They are not the problem. The problem is Americans are not going to rally for an insurance bailout. And, really, Americans do bear the full brunt of their health care costs, they just don’t know how looted they are being, because no one, including the Democrats are telling them. Someone suggested paychecks should show the employer contribution to health insurance. Everyone who understands basic economics knows the employer contribution is passed on to the employee via lower wages. Americans suspect they are being taken advantage of by the private insurers, if they knew how much, they would be protesting this bailout on all sides, Left, Right and otherwise.
BDBlue
I had a conversation with my brother over the weekend and, although he has libertarian/conservative tendencies (based a lot on income and his tax rate), he’s the one who asked why we bailed out banks instead of helping mortgage holders. He noted that if the mortgage holders (and consumers generally) had been helped then a lot of bad paper would become good paper AND people would get to stay in their houses, helping stabilize the real estate market. He saw the bailout in large measure exactly the same way I did, as a ripoff for Wall Street.
It was just another reminder that a lot of these economic issues don’t break down along left-right lines (although the media is going to keep trying to sell that since it keeps the other 98% of us fighting one another). Instead, they break down between corporatists and the rest of us.
masslib
Also, I abhor the elites who claim Americans love their insurance. They don’t want change. If that were the case, how did health care become the big issue in the election? I do not believe for a minute that Americans would reject better, cheaper health care. It’s absurd. That’s why this plan is failing to rally people. Even with the weak public option, they can not say this plan will lower your household costs on health care, this plan means you won’t have to pay co-pays, deductibles, drug prices. This plan doesn’t do jack to help most Americans with their health care costs. Nor does it improve care except perhaps around the margins. What’s to support?
As an aside, I think I have figured out Wal-Marts endorsement, aside from the obvious, they’ll be able to shift people to Medicaid without much cost. I think if you did a SWOT analysis for Wal-Mart, I would bet their leading opportunity is becoming(if they haven’t already) the leading drug supplier in the country. Their most significant threat would be the government, if it passed laws to negotiate drug prices, and worse, passed single payer with full drug coverage. So we are saying the federal government shouldn’t use it’s market power in the same way Wal-Mart does. Flippin unreal.
Ian Welsh
Some of the bills grandfather in bad plans. So if they pass with that in it, Walmart is able to keep giving its bad plan to its employees which is cheaper than what other employers have to give to their employees, and that locks in a competitive advantage.
lambert strether
> Some of the bills grandfather in bad plans.
That’s the feature part. Where’s the bug?
tjfxh
The principle problem with change as President Obama observed, although not in these words is with the inertia due to the momentum of the socio-politico-economic system. Having created a system based on non-taxed employee benefits provided by private insurers the mass of the system is huge, being measured in trillions of dollars a year. Trying to change this system would involved introducing a countervailing force that the President doesn’t think practical, since he admitted that single-payer is the best choice objectively. He has come to similar view with respect to prosecution of war crimes. As a constitutional lawyer, the president knows the stakes here. so his decision apparently reflects pragmatism instead of principle.
While most progressives think that his pragmatism is shortsighted in light of probable consequences, the president and his advisers seem to have reached the conclusion that they best they can do with respect to effecting the change he promised is to act incrementally rather than to attempt to counter systemic inertia head on. You know the song: “When an irresistible force meets and immovable object, something’s gotta give.”The president apparently doesn’t think he can pull it off.
It seems to me that the problem is with the prevailing ideology. The opposition is primarily in terms of costs, with the implication of tax increases on the middle class. The president has fallen into the trap created by this framing of the issue in terms of cost-cutting instead of framing the issue in terms of the liberal values to which most of the public subscribes.
George Lakoff has observed that the left and right are conceptual frameworks, whereas the center is biconceptual, holding some frames from both right and left frameworks. The president has not paid enough attention to the left framework, while paying excessive attention to the right. This has weakened his argument and empowered the Blue Dogs, who are dominating the debate. The result emerging is a hodge-podge that favors existing interests and perpetuates many if not most of the problems. Ian is correct, the problem is not with the people, it is with the politicians, and the buck stops with the president.
Henery C. K. Liu proposes that the issue should be framed in terms of investment instead of cost-cutting. Investment pays for itself. Matters like education, basic science, infrastructure, national security, and health care make a country more prosperous by making it more competitive. These socio-economic factors are governmental responsibilities because they cannot be relegated to the private sector effectively, where profit and not outcome is paramount. The break down in the existing model shows that profit does not lead to a satisfactory outcome in health care.
But even we the frame is conceded to the right, there is an article in The New Scientist that argues a governmental solution is the only viable one because rising health care cost will otherwise crowd out all other private spending, resulting in economic and social disaster. Unchecked healthcare costs will ruin America
Conclusion? The president appears to be too timid. He seems to lack a comprehensive, coherent, practical, and inspiring vision and is therefore not able to lead the country into implementing it. Unless the president gets control of his party, the mandate he received will be wasted and the Democrats will be ejected from power much sooner than they would otherwise, as people look for real change elsewhere.
Cujo359
masslib: You’re right, the irony of the people saying we can’t afford single-payer or a public option is that we’re paying now, it’s just that the cost is hidden. I don’t know if the costs employers pay actually lower our wages, but they definitely have to come out of something. Whether it’s R&D, advertising, stock dividends – someone’s budget will suffer.
tjfxh: Hate to get all simple-minded on you, but there really is a far simpler explanation of why Obama isn’t out front on health care – it’s his natural position to lead from the rear. It’s also true that he understands that he doesn’t want all those campaign dollars from pharma, big health care, and insurance that are now going the Democratic establishment to find their way to the Republicans. The key to understanding his priorities are who he meets with when. He’s met with those folks early and often. Proponents of a better health care system get contacted when it’s time to support the cause.
In short, this isn’t about any form of inertia, except for Obama’s not wanting to get off the fence, where he can safely continue to occupy the White House.
John B.
cujo359 says:
“In short, this isn’t about any form of inertia, except for Obama’s not wanting to get off the fence, where he can safely continue to occupy the White House.”
well, this seems to be true, but it is also true that Mr. Obama’s stay at the White House will be shorter than would have been expected given his mandate and his early popularity.
I think tjfxh ( a truly hard name to remember) is correct. People will look for change elsewhere…
tjfxh
@Cujo359
I was simply stating Obama’s own rationale as he has often expressed it. He positions himself as a centrist pragmatist. Based on his own rationale, Being pragmatic means that he places expediency above principle. Many would equate this with timidity in a leader when it seems like he is allowing himself to get rolled by powerful interests.
The problem with being “pragmatic” is that people don’t know where you actually stand. As a result, one runs the risk of coming across as weak and vacillating. This is a growing perception. Apparently backing down to Russia won’t help this perception, especially in the face of right wing attacks about being “soft.”
I have consistently said that, “Follow the money,” is the overarching principle in contemporary. The real problem that the president faces is that this involves not only health care but also finance. It’s pretty clear that he’s either afraid to stand up to the banksta’s or sold out to them. Which worse to be weak or corrupt? I’m afraid that many people are beginning to suspect the latter.
There is currently a discussion going on regarding whether Obama is naive, timid, or complicit. Jesse: Ding, didng, ding.
Jim
Headline and cuts from the editorial section of the Helena Independent Record September 21, 2009 :
“MOST WOULD VOTE FOR SINGLE-PAYER”
“Sen. Max Baucus, D-Mont., unveiled his and the Finance Committee’s health reform bill last week, but it didn’t contain any provision for single payer or a government option.
“An overwhelming percentage of respondents to our unscientific – and hypothetical – poll wished there was such an option.
“As of Friday afternoon, 593 respondents said they would vote for a single-payer health insurance option if it were a national referendum, while 130 said they would not. That’s 82 percent of the 723 respondents who would vote for single-payer.”
Helena is the capital of Montana.
Mandos
Ian: I’m afraid your conclusion is something vaguely like question-begging. If the hunger for change really exists, and it is American Democratic politicians that are failing to lead, then American Democratic politicians are therefore obstacles to positive change. (Duh.)
Then why doesn’t the public use any number of constitutional means to effect change by replacing the politicians in question? The only people who are agitated are those most emotionally attached to the status quo.
So I’m afraid that the intensity argument still stands pretty well. Americans, for whatever reason, may want health care via single-payer, but they don’t want it enough to raise the political cost of noncompliance.
Mandos
We have to understand that we have entire generations of people who have been raised on Sesame St. morality plays, where the highest value is social reconciliation and “sharing,” and where defeat of oppression is reduced to denying Cookie Monster an unfair share of cookies. And an educational system whose disciplinary procedures are designed to punish neutrally both perpetrator and victim of bullying, and so on.
This has had both costs and benefits. One of the costs is that many people really do believe that it’s the job of a “good” president to make sure that all interest groups achieve consensus…and that Bush’s fault wasn’t that he was an instrument of the Lords of Misrule, but that his administration was too pugnacious in some way.
tjfxh
It’s About Who Runs The Country and President Obama is the decider.
Mandos
Bowers point is not a bad one. There’s a case to be made that no bill is better than a bad bill (duh), but there’s a nontrivial case to be made that a bad bill is better than no bill, because in some quarters among the People Who Matter even the act of reform is controversial.
Cujo359
tjfxh : In some ways, it probably doesn’t matter if weakness or corruption is to blame. Obama was known as “Mr. Present” in the Illinois legislature for his habit of voting “present” on bills that were too controversial. It was a very pragmatic course, but not terribly inspiring. Corruption can be considered pragmatic, too. After all, it’s going to be harder for Obama to be re-elected, and much harder to keep Democratic majorities in Congress, if he pisses of pharma, insurance, the banks, and Wall Street. If the money they give to Democrats now goes to Republicans instead, the political situation could look very different in a couple of years.
So, weakness, corruption, it usually comes down to the same thing – Obama will choose the safer and easier course. The trick, I suppose, is to make what we want the easier course.
Jim: A couple of things that smart politicians know are important to remember here:
First, if this was an internet survey they’re talking about, it doesn’t mean squat. Many is the time when PZ Myers has had his readers crash some Internet poll or another. You’d be amazed at how popular positions atheists take on issues of freedom of religion and church-state separation are in these polls.
Second, they also know that people are all for radical change until they’re the ones that have to give up something. I think you can assume that the difference in popularity between the public option and single-payer is that in the former, people won’t have to give up their insurance if they want to. Once politicians start mentioning particular things that are going to affect folks, popularity of that particular course will go down.
What Republicans and other opponents of reform have been very good at doing lately is scaring people about what it is that they’ll lose – death panels killing granny, and so forth. One of the things that are happening now is that voters are making their fears known, and support for both a public option and single payer are waning.
tjfxh
Of interest:
Paul B. Farrell: ‘Reaganomics, A Love Story: The Epic Movie’ 13 scenes plot Wall Street’s conspiracy to destroy America’s capitalism
Ian Welsh
Mandos? And what should they do, exactly? In 2006 the American people returned a Democratic Congress with a mandate to end the war. In 2008 the American people returned a larger Democratic Congress and a President, with a mandate for, among other things, health care reform. It seems to me the American people have done much of what is supposedly required to get change, but American politicians keep refusing to give it to them.
Mass demonstrations for or against policies in the last 10 years also haven’t done a damn thing to get those policies enacted.
I agree Americans (or rather Democratic primary constitents won’t nominate real left wingers for the Presidency) but overall the American people keep voting for change – then not getting it.
What are the American people supposed to do, exactly? What would greater intensity get them? They kicked out one group of people, gave super majorities to the Democrats and still aren’t getting what they voted for.
US democracy may be broken, but it doesn’t look to me like it’s mostly broken at the popular end, except to the extent that Americans aren’t willing to go all French and just shut the country down in exasperation. If that’s the level of intensity needed, then Americans aren’t intense enough.
Americans keep voting for change. Politicians keep not giving it to them.
BDBlue
I intend to write more about this, but I suspect the “intensity” we’re going to see from Americans is going to come in terms of debt non-repayment (some strategic, some because they don’t have the money, some because they have had it) and tax non-compliance. In fact, if a really bad healthcare bill passes, I expect to see relatively large levels of non-compliance. When you have a government spending its tax dollars time and again on things people don’t support (two wars, the bank bailout, etc.) and that doesn’t respond to democratic action, that’s what you risk. And, really, what will Versailles’ complaint be? They’ve been telling us for the past several years that the law isn’t the law when it comes to some people. So what happens if a lot of Americans decide they are those some people.
Mandos
Now who is the pessimist? 🙂
They could have voted for third parties—I mean, in many places, third party and independent candidates exist. They could have “primaried” away right-wing Democrats/Blue Dogs.
Unless you believe actual vote-rigging is going on, you can’t coherently argue that USians have no options. It’s been the case for a long time, and certainly from Bill Clinton’s time, that the Democrats are hardly even social democrats, as a party. I mean, it’s visible and known.
So the question to answer is why USians haven’t exercised their options. Or, you could simply go further than my previous suggestions and say that the People Who Matter have it so much in the bag that you could elect Lenin and he’d behave like Reagan.
tjfxh
Progressive economist Dean Baker on a left-right populism to confront the power elite that is hijacking the country”
The Rally Against Obamacare for the Banks
b.
“So, no, the problem isn’t American citizens not having the appetite for necessary radical change. The problem is American politicians.”
And fairly balanced people like Klein.